Pull-Through Donning Technique – Instructions
This pull-through technique is helpful when the stump shape or fit prevents the insert from being fully applied. This often occurs when the stump has significant soft floppy tissue or when the stump is bulbous in shape. The distal end of the residual limb is usually intended to touch or reach the bottom of the foam insert.
Fig.1: Shows a lack of contact that can be problematic. A flap is cut through the distal end of the soft insert to draw the pull sock through.
This also allows visual inspection of the distal fit.
Fig. 2: Create a nylon tube by cutting the end off a nylon sheath.
Apply the sheath approximately half way up the residual limb over the desired ply of stump sock. Leave a long tail to pull through.
Fig. 3: Draw the nylon tail through and ensure that the residual limb has good distal contact.
As this is done, it is essential to push up on the distal end of the insert. Ensure when finished that the insert is fully donned. Check for distal contact and proper patella bar location.
Fig. 4: Reflect the rest of the nylon sheath over the insert to facilitate sliding into the socket.
The outer nylon sheath holds the distal flap closed, and is also used later as a handle to doff the outer socket.